Research On Egfr Genic Mutation Andbrca-2、ER、PR、C-erbB-2Expression In Nsclc

Background and Objective:Lung cancer is one of the most prevalent malignant tumors to human health with highest mortality rate.Non–small cell lung cancer, which accounts for80%of lung cancer, is difficult to diagnose at its earlystage, leading to70%-75%of their patients losing operation opportunity. After decades of basic and clinicalresearch, although the diagnosis and treatment methods have developed much, the patient’s living qualityand tumor free survival have been improved, and the five year survival is still low. In the past ten years, themorbidity of lung cancer in men has gone down, but it is rising in women. Smoking is a risk factor for lungcancer. The majority of lung cancer in women is adenocarcinoma, and the EGFR gene mutation is higher inwomen than in men. It will be better treated with targeting drug such as gefitinib. The difference of lungcancer epidemiology between male and female urges people to explore more about the performance of sexhormone in lung cancer.Endocrine therapy has achieved great success in breast and ovarian cancer, and it improves thepatients’ prognosis. It also has been confirmed that estrogen receptor can promote cancer progress in someof organs, including the non small cell lung cancer. Research shows that there is some relationship betweenestrogen and NSCLC ’s biological behaviours. Estrogen stimulates the NSCLC deviding, and this processcan be reversed by estrogen inhibitor. As one of the environment factors, estrogen inhibitor has beenapplied in lung cancer’s endocrine therapy. But it’s effect is still controversial. The expression level ofestrogen receptor and progesterone receptor in NSCLC is still different in different research..The susceptibility breast cancer gene BRCA-2, as an important tumor suppressor gene, its expressionshas close relationship with the prognosis of breast and ovarian cancer. However, only a few researchesrelated to lung cancer show that the high expression of BRCA-2would increase the morbidity of NSCLCfemale patients above60. Therefore, our study will focus on the relationship between the expression andclinical pathology of BRCA-2、ER、PR and C-erbB-2in NSCLC based on the current research studies ofsex hormone in NSCLC. Moreover, as most gene mutation in NSCLC patients are female, we will alsoexplore the relationship between EGFR gene mutation and other gene expression, in order to offer moreevidences for individual and comprehensive therapy of NSCLC. Methods:84NSCLC samples were collected. BRCA-2、ER、PR and C-erbB-2expression were tested byimmunohistochemistry. EGFR gene mutation was detected by TaqMan Real-Time PCR. SPSS13.0softwarewas applied to analyze the data.Results:In the84NSCLC samples, the positive expression rate of BRCA-2、ER、PR and C-erbB-2are41.7%、50%、57.1%and17.8%. The expression level are higher in BRCA-2patients who has meet these conditions:menopause(P=0.046), female（P=0.003）, positive lymph node metastasis（P=0.041）and tumor diameterless than3cm（P=0.037). There are positive correlation among the expression of BRCA-2and ER（r=0.242,P=0.037）, C-erbB-2（r=0.206, P=0.021）; the expression of ER and C-erbB-2（r=0.277, P<0.001）; inaddition, the positive expression for PR is related to patients’ gender and the degree of differentiation oftumor. But the EGFR gene mutation has no correlation （χ2=7,642, P=0.076）with the patients’ age（χ2=4.418, P=0.077), the transfer degree of lymph node（χ2=5.192, P=0.063）and the differentiationdegree (χ2=4.125, P=0.068). However, there is a significant correlation between EGFR gene mutationand the patients’ gender（χ2=6.133, P=0.016）,smoking （χ2=6.172, P=0.031）, menopause（χ2=5.126,P=0.028）, tumor diameter （χ2=7.170, P=0.032） and pathological category （P=0.027）. Female(OR=2.012;95%CI,1.411to3.928; P=0.024）and the negative expression of PR（OR=1.982;95%CI,1.025to3.825; P=0.031） are two independent factors for EGFR gene mutation in NSCLC patients.Conclusions:1）There are BRCA-2and C-erbB-2expression in NSCLC;2）The expression of C-erbB-2has apositive correlation with the expression of ER and BRCA-2in NSCLC;3)The detection rate of EGFR genemutation are relatively high in NSCLC when the PR expression is negative,and the negative expression ofPR is associated with better clinical pathology in patients;4) Female and the negative expression of PRare two independent factors for EGFR gene mutation in NSCLC patients.